Scandinavian quality register for thyroid and parathyroid surgery: audit of surgery for primary hyperparathyroidism
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Background and aim
Scandinavian Quality Register for Thyroid and Parathyroid Surgery is an on-line web-based database with the aim to improve the quality of thyroid and parathyroid surgery. Preliminary data from surgery for primary hyperparathyroidism are reported here.
Materials and methods
Fifteen departments registered 806 operations, with 639 women (79.7%) and 167 men. The median age of the patients was 62 years.
Approximately 95.4% of the patients had sporadic disease and first time operation was performed in 93.8% of the patients. Localization examinations were performed in 524 patients (65%); sestamibi scintigraphy in 413 patients, with a true positive adenoma localization in 64.4% and ultrasound in 293 patients with adenoma localization in 61.1%. Bilateral neck exploration was performed in 66.8%, unilateral exploration in 16.1%, and focused minimal invasive surgery in 17.1%. In 301 patients planned for limited parathyroid exploration, conversion to bilateral neck surgery occurred in 11%. The cure rate, based on short follow-up, was 91.9%. Postoperative hypocalcemia occurred in 11.4% of the patients, and was associated with reoperation, concomitant thyroid operation, and the weight of excised parathyroid tissue.
Localization examinations are performed in 2/3 of the patients, but limited neck exploration was performed in only approximately 1/3 of the operations. The cure rate was lower and postoperative hypocalcemia was more frequent than expected.
KeywordsPrimary hyperparathyroidism Audit Surgery Outcome Complications
The present investigation was supported by grants from: European Union (Interreg. IIIA) and Swedish National Board for Health and Social Welfare. The following departments are currently participating in the Scandinavian Quality Register for Thyroid and Parathyroid Surgery: Department of Breast and Endocrine Surgery, Copenhagen University Hospital Rigshospitalet; Department of Surgery, Central Hospital, Kristianstad; Organkirurgisk Afdelning, Horsens Sygehus; Department of Surgery, Helsingborg Hospital; Department of Surgery, University Hospital of Uppsala; Center for Metabolism and Endocrinology, Karolinska University Hospital-Huddinge; Department of Surgery, Central Hospital, Halmstad; Department of Surgery, Falu Hospital; Department of Surgery, Ljungby Hospital; Department of Surgery, Växjö Central; Hospital Department of Surgery, Södersjukhuset; Department of Surgery, Västerås Central Hospital; Department of Surgery,Vendsyssel Hospital; Department of Otorhinolaryngeology, Lund University Hospital; Department of Surgery, Karolinska University Hospital; Department of Surgery, Sunderby Hospital; Department of Surgery and Transplantation, Sahlgrenska University Hospital; Department of Surgery, Kalmar Central Hospital; Department of Surgery, Randers Central Hospital; Department of Surgery, Nyköping Hospital; Department of Surgery, University Hospital of Umeå; Deparment of Surgery A,Odense University Hospital; Department of Surgery, Norra Älvsborgs Länssjukhus; and Department of Surgery, Lund University Hospital.
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